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General NPI Number Information
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NPI Number | 1164226601
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Entity Type | Organization
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Legal Business Name | SARA JOHNSON-CARDONA COUNSELING LLC
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 8548 BRYAN AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1309
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Country | US
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Telephone | 314-803-6589
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Fax |
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Provider Business Mailing Address
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Address Line | 8548 BRYAN AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1309
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Country | US
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Telephone | 314-803-6589
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARA CARDONA
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Credential |
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Telephone | 314-803-6589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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